| NPI | 1730622671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR45992) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 062304) |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2016-11-27 |